scholarly journals Allergic Fungal Rhinosinusitis in Saudi Arabia: A Review of Recent Literature

Cureus ◽  
2021 ◽  
Author(s):  
Abdussalam A AlAhmari
Keyword(s):  
Saudi Arabia ◽  
Recent Literature ◽  
Fungal Rhinosinusitis ◽  
Allergic Fungal Rhinosinusitis

scholarly journals Allergen Immunotherapy in an HIV+ Patient with Allergic Fungal Rhinosinusitis

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Ian A. Myles ◽  
Satyen Gada
Keyword(s):  
Allergen Immunotherapy ◽  
Severe Infection ◽  
Invasive Fungal Disease ◽  
Fungal Disease ◽  
Fungal Sinusitis ◽  
Opportunistic Pathogens ◽  
Fungal Rhinosinusitis ◽  
Allergic Fungal Rhinosinusitis ◽  
Invasive Fungal Rhinosinusitis ◽  
Chronic Invasive

Patients with HIV/AIDS can present with multiple types of fungal rhinosinusitis, fungal balls, granulomatous invasive fungal rhinosinusitis, acute or chronic invasive fungal rhinosinusitis, or allergic fungal rhinosinusitis (AFRS). Given the variable spectrum of immune status and susceptibility to severe infection from opportunistic pathogens it is extremely important that clinicians distinguish aggressive fungal invasive fungal disease from the much milder forms such as AFRS. Here we describe a patient with HIV and AFRS to both remind providers of the importance of ruling out invasive fungal disease and outline the other unique features of fungal sinusitis treatment in the HIV-positive population. Additionally we discuss the evidence for and against use of allergen immunotherapy (AIT) for fungal disease in general, as well as the evidence for AIT in the HIV population.

Sinonasal Surfactant Protein A1, A2, and D Gene Expression in Cystic Fibrosis: A Preliminary Report

2007 ◽  
Vol 137 (1) ◽  
pp. 34-38 ◽  
Author(s):  
Bradford A. Woodworth ◽  
Rachel Wood ◽  
John E. Baatz ◽  
Rodney J. Schlosser
Keyword(s):  
Gene Expression ◽  
Cystic Fibrosis ◽  
Nasal Polyposis ◽  
Quantitative Polymerase Chain Reaction ◽  
Surfactant Protein ◽  
Fungal Rhinosinusitis ◽  
Allergic Fungal Rhinosinusitis ◽  
Novel Treatment ◽  
Polymerase Chain

OBJECTIVE: To measure alterations in SPA1, A2, and D gene expression in various forms of inflammatory chronic rhinosinusitis (CRS). STUDY DESIGN AND SETTING: Sinus mucosal biopsies were performed in patients with allergic fungal rhinosinusitis (AFS), CRS with nasal polyposis, cystic fibrosis (CF), and controls. SP mRNA was measured with quantitative polymerase chain reaction. RESULTS: Patients with CF (n = 4) showed significantly increased SPA1 (82-fold), SPA2 (100-fold), and SPD (47-fold) mRNA ( P < 0.05) when compared with controls (n = 5). Patients with CRS with nasal polyposis (n = 5) also demonstrated elevated SPA1 (27-fold), SPA2 (13-fold), and SPD (13-fold). Patients with AFS (n = 7) had increased SPA1 (5-fold), SPA2 (9-fold), and SPD (17-fold), but were not statistically significant. CONCLUSION: SPA1, A2, and D are upregulated in various forms of CRS, but are significantly elevated in cystic fibrosis CRS. SIGNIFICANCE: Understanding the role of SPs in CRS will help develop novel treatment approaches for sinonasal pathoses.

scholarly journals Allergic fungal rhinosinusitis: an overview on pathogenesis, early diagnosis and management

2018 ◽  
Vol 4 (3) ◽  
pp. 694 ◽  
Author(s):  
Neeraj Suri ◽  
Bhavya B. M.
Keyword(s):  
Nasal Obstruction ◽  
Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Histological Evaluation ◽  
Nasal Discharge ◽  
Fungal Sinusitis ◽  
Surgical Specimen ◽  
Specimen Handling ◽  
Fungal Rhinosinusitis ◽  
Allergic Fungal Rhinosinusitis

<p class="abstract"><strong>Background: </strong>The objective of the study was<strong> </strong>to evaluate the criteria for diagnosing allergic fungal rhinosinusitis and to maintain permanent drainage and ventilation, while preserving the integrity of the mucosa.</p><p class="abstract"><strong>Methods:</strong> This is a prospective study of 50 patients with allergic fungal sinusitis with or without polyposis all of whom were treated with endoscopic debridement. Mucous sample collection, nasal secretion culture, surgical specimen handling, and histological evaluation of surgical specimens are described. All patients treated with endoscopic sinus surgery, debridement, post-operative use of steroids and antifungal therapy.  </p><p class="abstract"><strong>Results:</strong> Fungal mucin was found in all 50 cases, histology and fungal cultures confirmed the diagnosis. Out of 50 patients, 29 were females and 21 were males, with a mean age of 32 years. The most common symptom was nasal discharge 41 (82%) cases, nasal obstruction in 38 (76%) cases, headache and facial pain in 32 (72%) cases, 7 (14%) patients had bronchial asthma. Symptoms of nasal obstruction and nasal discharge were improved in 46 (92%) cases. All preoperative versus postoperative changes in AFRS associated complaints reached statistical significance of p value &lt;0.001 except in patients with asthma.</p><p class="abstract"><strong>Conclusions:</strong> Comprehensive management with endoscopic sinus surgery, oral steroids and antifungals reduces the recurrence or need for revision surgery. Long term follow up is very important.</p>

Evaluation of the Role of Immunotherapy in Allergic Fungal Rhinosinusitis

2021 ◽  
Vol 30 (3) ◽  
pp. 111-117
Author(s):  
Ghada A. Mokhtar ◽  
Sylvia W. Roman ◽  
Aya M. Elgendy ◽  
Marian A. Gerges ◽  
Alsayed Abdulmageed ◽  
...  
Keyword(s):  
Endoscopic Examination ◽  
Type I ◽  
Fungal Culture ◽  
Total Ige ◽  
Prick Test ◽  
Fungal Rhinosinusitis ◽  
Allergic Fungal Rhinosinusitis ◽  
Fungal Allergens ◽  
Type I Hypersensitivity

Background: Allergic fungal rhinosinusitis (AFRS) is a distinct form of chronic rhinosinusitis. Type I hypersensitivity to inhaled fungal allergens has been implicated as key pathogenesis. Immunotherapy as one of the therapeutic options is still controversial. Objective: to evaluate the role of immunotherapy in the management of AFRS patients not responding to medical treatment 3 months following endoscopic surgery. Methodology: A total of 35 patients diagnosed as resistant AFRS were included in this prospective study. Patients were diagnosed following clinical, radiological, and endoscopic examination of nose and paranasal sinuses. Specimens were collected during endoscopy and subjected to microscopic examination and fungal culture. Skin prick test and assessment of total IgE level were performed for all patients. Sublingual immunotherapy (SLIT) was initiated for all patients for 6 months. Clinical efficacy of SLIT was assessed using the 20-item sino-nasal outcome test (SNOT-20) score. Results: Aspergillus spp. was the most frequent fungus isolated (74.3%) from patients. All patients were sensitized to mixed fungi. Elevated total IgE (> 100 IU/mL) was found in all patients with 40% of them had peripheral eosinophilia. A significant improvement (p < 0.001) was recorded in the SNOT-20 score of examined patients recording a mean of 1.2 ± 0.3, 6 months after SLIT compared to 1.93 ± 0.44 before immunotherapy initiation. Conclusion: Immunotherapy appears to be a good adjunctive therapy for the management of resistant cases of AFRS.

Revision Surgery for Allergic Fungal Rhinosinusitis

2008 ◽  
pp. 153-157
Author(s):  
Subinoy Das ◽  
Patricia A. Maeso ◽  
Stilianos E. Kountakis
Keyword(s):  
Revision Surgery ◽  
Fungal Rhinosinusitis ◽  
Allergic Fungal Rhinosinusitis

Radiologic Staging System for Allergic Fungal Rhinosinusitis

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P80-P80
Author(s):  
Gamwell A Rogers ◽  
Sarah K Wise ◽  
Mark D Ghegan ◽  
Richard J Harvey ◽  
John M DelGaudio ◽  
...  
Keyword(s):  
African Americans ◽  
Sphenoid Sinus ◽  
Bone Erosion ◽  
Tertiary Care ◽  
Staging System ◽  
Disease Course ◽  
Fungal Rhinosinusitis ◽  
Allergic Fungal Rhinosinusitis ◽  
Sinus Wall ◽  
Patient Groups

Objective (1) To develop an objective method for quantifying radiologic bone erosion in allergic fungal rhinosinusitis (AFRS). (2) To assess the utility of the newly developed AFRS CT staging system in differentiating AFRS patient groups. Methods Patients from two tertiary care rhinology practices with classic AFRS and available CTs (2001–2007) were included for retrospective review. CTs were scored by trained graders not involved in the patients’ care as the primary treating surgeon. The following novel assessment scale was used: Each paranasal sinus wall with expansion/erosion was scored 1 point, with a maximum of 3 points possible for each frontal sinus, 2 points for each ethmoid complex, 3 points for each sphenoid sinus, 3 points for each maxillary sinus, 1 point for the frontal intersinus septum, and 1 point for the sphenoid intersinus septum, yielding a maximum of 24 possible total points. Results 111 CTs were reviewed. Mean score across all patients was 7.8 (range 0–24). Males scored significantly higher than females (mean 9.3 vs 5.6, p < 0.001). African Americans scored significantly higher than Caucasians (mean 9.6 vs 5.0, p < 0.001). There was also a trend towards younger patients exhibiting higher scores (p = 0.07). Conclusions A radiologic grading system for bone erosion/expansion in AFRS is presented, which is easy to apply and may objectively stratify disease severity. Males and African Americans with AFRS demonstrate significantly more bone erosion. Additional analysis of disease course will assess the potential utility of this staging system in predicting outcomes.

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